Individual provider Active NPI

Stephanie Lynn Van Colen, D.O.

  • Diagnostic Radiology Physician
  • Fall River, MA
National Provider Identifier
1700045440
Registry record updated Jan 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
239457 Issued in MA
Practice address
363 Highland Ave
Fall River, MA 02720-3703
Phone
(508) 679-7136
NPI assigned
Jun 6, 2008
Last updated
Jan 28, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 239457 MA Primary

Addresses

Primary practice location

363 Highland Ave
Fall River, MA 02720-3703

Mailing address

363 Highland Ave
Fall River, MA 02720-3703
Phone (508) 679-7136

Other identifiers 1

IdentifierTypeStateIssuer
110083150AMedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, RI2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20090827000066 MA Practitioner - Diagnostic Radiology 3779638788 Reassigns benefits to 3 organizations
I20200125000118 RI Practitioner - Diagnostic Radiology 3779638788 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of New England, College of Osteo Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern New England Radiology IncGroup PAC ID 9931404084, 22 clinicians

Practice addresses (Care Compare)

363 Highland Ave
Fall River, MA 02720-3703
Phone (508) 679-7136

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
239457MAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Steward Medical Group, Inc CurrentSince Jun 10, 2015 Accepting new patients
Southern New England Radiology Inc Diagnostic Radiology CurrentSince Feb 1, 2020 Accepting new patients
Steward Medical Group, Inc CurrentSince Jun 10, 2015 Accepting new patients

Locations

736 Cambridge St
Brighton, MA 02135
Phone (617) 789-2762

235 N Pearl St
Brockton, MA 02301
Phone (508) 427-2525

363 Highland Ave
Fall River, MA 02720
Phone (508) 679-7052

795 Middle St
Fall River, MA 02721
Phone (508) 235-5046

851 Middle St
Ste 2100
Fall River, MA 02721
Phone (508) 235-5445

300B Faunce Corner Rd
North Dartmouth, MA 02747
Phone (508) 973-1020

531 Faunce Corner Rd
North Dartmouth, MA 02747
Phone (508) 991-2255

909 Sumner St
Stoughton, MA 02072
Phone (508) 427-2480

672 Aquidneck Ave
Middletown, RI 02842
Phone (401) 847-0519

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1212710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580169600000",
    "number": "1700045440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "363 HIGHLAND AVE",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "027203703",
            "telephone_number": "508-679-7136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "363 HIGHLAND AVE",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "027203703",
            "telephone_number": "508-679-7136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN COLEN",
        "first_name": "STEPHANIE",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-06",
        "last_updated": "2020-01-28",
        "certification_date": "2020-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "239457",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110083150A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fall River, MA

Sources for this page

Verify at the official NPI Registry.